ITS 92 - Consumption Junction, What’s Your Function: Implementation of Structured Review for Suspected Tuberculosis Cases

Background: Communicating important epidemiological and clinical details to determine if airborne infection isolation can be discontinued in patients undergoing evaluation for Tuberculosis (TB) is essential for patient and healthcare personnel (HCP) safety and impacts healthcare facility capacity; however, this presents a time-intensive task for Infection Preventionists (IP). Varying IP workflows can result in inefficiencies and delays in isolation discontinuation. The effectiveness of structured data collection was piloted as part of a quality improvement initiative.

Methods: An electronic health record (EHR) template was developed to define and structure the elements of TB case abstractions for IPs at a large academic medical center. Intradepartmental communication and efficiency of case review, which included IPs and physician medical directors within infection control (IC), was evaluated. Outcomes assessed included IP time completing case abstraction and a quantitative survey of IPs and physicians using a 5-point Likert scale that assessed perceptions of the impacts of the template.

Results: Between 11/1/2023 and 11/30/2023 36 TB case abstractions were created using the template. The mean time spent by 9 IPs creating each case abstraction was 24 minutes. 33% of case abstractions required 1 follow up with a mean follow-up time of 8 minutes. 9/9 IPs completing the survey reported agreement or strong agreement that the template positively impacted their workflow regarding communication, quality, continuity, and efficiency. Both IC physician medical directors were queried on communication, quality and efficiency and reported agreement or strong agreement of improvements in communication, quality, and continuity; one physician was neutral regarding impact on efficiency.

Conclusions: Reports from using a small pilot assessment indicate that the use of a standardized template improves content quality, increases efficiency, promotes workflow continuity, and creates more effective intradepartmental communication when reviewing patients undergoing evaluation for active TB and determining the need for continued isolation.